IPACHTE# 0 7 Harnett County Department of Public Health 2 5 6 2 0
Improvement Permit
A building permit cannot be issued with only an Improvement Permit
46 ll PROPERTY LOCATIO
ISSUED T0: n~t SUBDIVISION A-c+- ,4 L 0 T # '7_2
NEW -Pr- REPAIR ❑ EX NSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: - t y(~ t(~
Proposed Wastewater System T~Ype: Cc9 ti u~ .c a~
Projected Daily Flow: GPD
Number of bedrooms: 3 - Number of Occupants: max
Basement ❑Yes -R No
Pump Required: ❑Yes ~T No ❑~May bb required based on final location and elevations of facilities
Type of Water Supply: ❑ Community 2' Public ❑ Well Distance from well feet Permit valid for. ~e years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: .2i SEE ATTACHED SITE SKETCH
The issuance of this permit by the H Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if t site plan, plat, or the intended use changes. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into this permit and shall be met. Systems shall be installed in accordance
with the attached system layout
ISSUED TO: C,c,nn . ng.J PROPERTY LOCATION- JZ fl~ /
SUBDIVISION 1 LOT # _2 2,
Facility Type: 2"New ❑ Expansion ❑ Repair
Basement? ❑ Yes EI'l-o Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** G on J<'.~~ic.~ Q (Initial) Wastewater Flow: Q GPD
(See note below, if applicable
aS'~ ~ei -a,c-,- (Repair)
Installation Requirements/Conditions Number of trenches 3
Septic Tank Size (MG gallons Exact length of each trench feet
Pump Tank Size gallons Trenches shall be installed on contour at a
Maximum Trench Depth inches
(Trench bottoms shall be level to +/-1/4"
in all directions)
Pump Requirements: ft. TDH vs. GPM
jtions: , 3 . err t~ trams' t71U . ,c.~,
Q : /vc,sP A. +4--- . C T/f r~ ~ of -
Trench Spacing: Feet on Center
Soil (over. Z inches
(Maximum soil cover shall not exceed
36" above the trench bottom)
inches below pipe
Aggregate Depth: inches above pipe
inches total
~r ec.1'
c- t'k vJ f 2 o 4, 4- W Sf S f Jae M
*If applicable: / understand the system type specified is different from the type specified on the application. / accept the soecAcationr of thin permit
Owner/Legal Representative Signature: Date:
This Construction Authorization is subject to revocation if the site plan, plat, or the intended use changes. The Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to compliance with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit SEE ATTACHED SITE SKETCH
Authorized State Agent~il ~ '~t:' Dat e:
Construction Authorization Expiration Date: ~i~/,)Q/
HTE# ag-~ ak-)kr Permit # 02,S(.aZCI
Harnett. County I)epartinent of 1"l blic nealth
v i to Sketch
PROPERTY LOCATON
ISSUED T0: l u~ c ib. CO Mme. •n SUBDIVISION t LOT #
c
Authorized State Agent: Date:
lei
Le k-kc..fc, C4.
Department of Environment, Health and Natural Resources
Division of Environmental Health
On-Site Wastewater Section
SOIIJSITE EVALUATION
for ON-SITE WASTEWATER SYSTEM
Owner: Applicant:
Address: Date Evaluated: )114vcf
Proposed Facility: Design Flow (.1949):
Location of Site: Property Recorded:
Water Supply: Ld Public ❑ Individual ❑ Well
Evaluation Method: uger Boring ❑ Pit ❑
Type of Wastewater: Sewage ❑ Industrial Process ❑
Sheet:
Property ID:
Lot
File
Code:
Property Size:
❑ Sung ❑ Other
cut
Mixed
P
R
O
F
I
1940
OIL MORPHOLOGY
.1941
THER
PROFILE FACTORS
L
E
#
Landscape
Position/
slope %
Horizon
Depth
(In.)
.1941
Stsucwe/
Texanre
.1941
Consistence
Mimnb
.1942
Soil
wetness/
Color
.1943
Soil
Depth IN.
.1956
Sapro
Class
.1944
Restr
Horiz
Profile
Class
& LTAR
Lmscn1uon Initial Repay System Other Factors (.1946):
s stem Site Classification (.1948r /d
Available Space .1943Evaluated By A--
System 2) OILY- C _„v
ZtA / TAR 0lhers Present: